Ohmit S E, Monto A S
Department of Epidemiology, University of Michigan, Ann Arbor 48109-2029, USA.
Int J Epidemiol. 1995 Dec;24(6):1240-8. doi: 10.1093/ije/24.6.1240.
Influenza vaccine effectiveness evaluations were carried out among the elderly, as part of a demonstration established to estimate the value of including influenza vaccination as a covered Medicare benefit.
Cases hospitalized with pneumonia and influenza-related diagnoses during November through April were identified and group matched to randomly selected community controls. Data were collected from cases and controls on influenza vaccination status and other factors which could have confounded the association between vaccination and hospitalization. A community-based influenza surveillance programme was conducted each year to determine the timing and aetiology of influenza activity. Logistic regression analyses were carried out to evaluate the association of influenza vaccination with the likelihood of hospitalization.
In 1990-1991, during the peak of the influenza type B outbreak, influenza vaccination was estimated to be 31% (95% CI: 4-51%) effective in reducing the likelihood of hospitalization. In 1991-1992, during the peak of the influenza type A(H3N2) epidemic, a nearly identical point estimate for vaccine effectiveness was demonstrated (32%, 95% CI: 7-50%). Identical analyses carried out each year during the periods of low or absent influenza activity failed to demonstrate a significant effect for vaccination in preventing hospitalization.
Results indicated that a significant benefit for vaccination could be expected during both type A and type B influenza seasons.
作为一项旨在评估将流感疫苗接种纳入医疗保险覆盖范围价值的示范项目的一部分,对老年人进行了流感疫苗效果评估。
确定11月至次年4月期间因肺炎和流感相关诊断住院的病例,并与随机选择的社区对照进行组匹配。收集病例和对照的流感疫苗接种状况及其他可能混淆疫苗接种与住院之间关联的因素的数据。每年开展一项基于社区的流感监测项目,以确定流感活动的时间和病因。进行逻辑回归分析以评估流感疫苗接种与住院可能性之间的关联。
在1990 - 1991年乙型流感爆发高峰期,估计流感疫苗接种在降低住院可能性方面的有效性为31%(95%置信区间:4 - 51%)。在1991 - 1992年甲型(H3N2)流感流行高峰期,疫苗有效性的点估计值几乎相同(32%,95%置信区间:7 - 50%)。在流感活动低或无的时期每年进行的相同分析未能证明疫苗接种在预防住院方面有显著效果。
结果表明,在甲型和乙型流感季节都可预期疫苗接种有显著益处。